胆囊切除术前后CCK-A的表达水平及其临床意义-现代医学

胆囊切除术前后CCK-A的表达水平及其临床意义

作者：王瑞陈虎

单位：泗洪医院普外科, 江苏泗洪 223900

分类号：R605

出版年·卷·期（页码）：2025·53·第二期（223-228）

摘要：

目的：探讨胆囊切除术前后血清胆囊收缩素受体A (CCK-A)表达水平及其在治疗胆结石中的临床疗效。方法：选取2022年1月至2023年12月在泗洪医院接受腹腔镜胆囊切除术的胆结石患者120例。检测患者术前和术后血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和CCK-A水平。根据术后CCK-A表达水平的中位数将患者分为CCK-A高表达组(n=60)和CCK-A低表达组(n=60)。比较两组患者的临床指标，包括结石平均内径、手术时间、住院时间、术中出血量、肠蠕动恢复时间以及并发症发生率。结果：术后患者血清IL-6、TNF-α水平显著低于术前(P<0.05)，而CCK-A水平显著升高(P<0.05)。与CCK-A低表达组相比，CCK-A高表达组患者的结石平均内径较小[(1.2±0.3) cm vs.(1.8±0.4) cm]，手术时间较短[(45.6±8.2) min vs.(62.3±10.5) min]，住院时间缩短[(3.2±0.5) d vs.(4.8±0.7) d]，术中出血量减少[(15.3±3.2) mL vs.(25.6±4.8) mL]，肠蠕动恢复时间缩短[(24.5±4.2) h vs.(36.8±6.5) h]，并发症发生率降低(5.0%vs. 15.0%)，差异均具有统计学意义(均P<0.05)。结论：胆囊切除术可通过上调血清CCK-A表达，同时降低炎症因子IL-6、TNF-α水平，从而改善胆结石患者的临床预后。较高的CCK-A表达水平与更好的手术效果和更低的并发症发生率相关。

Objective: To investigate expression level of serum cholecystokinin receptor A(CCK-A) before and after cholecystectomy and its clinical efficacy in the treatment of gallstones. Methods: A total of 120 patients with gallstones who underwent laparoscopic cholecystectomy in Sihong Hospital from January 2022 to December 2023 were selected to detect the levels of serum interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) and CCK-A before and after surgery. Patients were stratified into high CCK-A expression group(n=60) and low CCK-A expression group(n=60) based on the median postoperative CCK-A levels. Clinical parameters including mean stone diameter, operative time, length of hospital stay, intraoperative blood loss, time to bowel movement recovery, and complication rates were compared between the groups. Results: Postoperative serum levels of IL-6 and TNF-α were significantly lower than preoperative levels(P<0.05), while CCK-A levels were significantly elevated(P<0.05). Compared with the low CCK-A expression group, the high CCK-A expression group demonstrated smaller mean stone diameter[(1.2±0.3) cm vs. (1.8±0.4) cm], shorter operative time[(45.6±8.2) min vs. (62.3±10.5) min], reduced hospital stay[(3.2±0.5) d vs. (4.8±0.7) d], decreased intraoperative blood loss[(15.3±3.2) mL vs. (25.6±4.8) mL], shorter time of bowel movement recovery[(24.5±4.2) h vs. (36.8±6.5) h], and lower complication rates(5.0% vs 15.0%). All differences were statistically significant(P<0.05). Conclusion: Cholecystectomy improves clinical outcomes in cholelithiasis patients through upregulating serum CCK-A expression and concurrently reducing inflammatory markers IL-6 and TNF-α. Higher CCK-A expression levels are correlated with better surgical outcomes and lower complication rates.

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